Health-Care Reform Raises Questions of Individual Rights

Article excerpt

HEALTH-CARE reform is not just a matter of dollars and cents. It
raises troubling issues of civil and constitutional rights; those
issues are just beginning to arise in the national debate.

The American Civil Liberties Union (ACLU) recently issued a
"Health Care Reform Bill of Rights." It identifies four
constitutional areas - equal protection, personal privacy, due
process of law, and freedom of religion and speech - in which
reforms could run afoul of basic rights.

While Washington policymakers are preoccupied with budgetary
complexities of hammering together a compromise reform plan, these
issues will likely surface with increasing urgency in months ahead:

* Access, or "redlining," issues usually relating to the
ability of the poor and minorities to get care equal to the
affluent.

* Privacy, including confidentiality of medical information
about people and the possibility that health-care reform could
demand a kind of national identity card.

* Whether some people, particularly illegal immigrants, should
be excluded from "universal" coverage.

* How to accommodate people, who for religious or other reasons,
choose healing methods other than traditional medicine.

"When the civil rights and civil liberties communities get into
health care, driven by a specific concern like abortion, they'll
see that the whole area really raises all the same questions about
employment discrimination, privacy, and due process as any other
huge federal program," says Lesley Harris, public-policy director
at People for the American Way.

Access questions deserve more attention than they're getting,
says Ken Wing, a University of Puget Sound law professor and a
physician. He sees "a rush to control costs and placate providers
and insurers but no bill of rights to guarantee access."
Minorities at the periphery

Health-insurance practices now force many minorities to the
system's periphery. "In the new plan, there has to be something to
deal with ... racial discrimination."

"Redlining," excluding people due to race, economic status, or
medical condition, is highlighted in an analysis of health-care
reform by a committee of the American Bar Association's Section on
Individual Rights and Responsibilities. Committee vice chairman
Robyn Shapiro says some levels of insurance coverage possible under
a new system raise questions of who gets what level of care. "Will
it reenforce a two-tiered system? …